Title Page
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Site conducted
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Conducted on
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Prepared by
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Hold Number
Primary Hold Information
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Is this an internal hold or customer complaint
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DATE ON HOLD:
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Production Date:
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Batch #('s):
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Cookie Flavor:
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Line:
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Shift:
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LOT Code:
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Prims LOT Code:
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Pallet #('s):
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Case Count:
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Customer:
Production Area('s) Involved:
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(Check all that apply)
- Warehouse
- Set up
- PreWeigh
- Mixing
- Production Room
- Other
Reason for Hold:
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(Be specific)
Corrective Actions:
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(Be specific)
Supervisors PRINT Employee Names- NO SIGNATURES
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Set Up
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Lead Mixer
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Front Line Lead
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Blue Label Approval
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Mixer
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Back Line Lead
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Forklift Driver
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Maintenance (if Hold is for metal)
Supervisor:
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Supervisor Signature:
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Date:
QC Tech Signature:
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Please Sign
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Select date
To be completed by Quality Control
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Food Safety Concern? Y or N
Final Disposition:
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Comments:
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*Attach HOLD communications and material*
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Dispositioned by:
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Date:
